Heart Disease- The Silent Killer
Created by:
Tricia Fleming, University of Kansas Dietetic Intern
Tammy Beason, MS, RD, Nutrition Education Specialist,
Family Nutrition Education Program
December 2001
What is Heart Disease?
A general term that covers a number of
diseases which affect the heart, including
coronary artery disease, heart-failure and
angina.
 Heart Disease is the number one killer in the
United States.

What Causes Heart Disease?

Atherosclerosis-fatty deposits of cholesterol

Hypertension- we will discuss in detail later.
Coronary Artery Disease
Occurs when the coronary arteries that
supply the heart muscle become blocked.

Partially blocked it causes angina.

Fully blocked it causes a myocardial
infarction or a heart attack!
Myocardial Infarction
or
Heart Attack
Symptoms: uncomfortable pressure,
fullness, squeezing pain, pain spreading to
the shoulders, neck and arms.
 Chest discomfort and light headedness
 Anxiety/nervousness
 Paleness or pallor
 Increased irregular heart rate

Myocardial Infarction contd.

Feeling of impending doom
If you or someone you know is having these
symptoms call 911!
Congestive Heart Failure
Fits under the description of heart disease.
 Does not mean the heart has failed, simply
means the heart is not doing an efficient job.
 It results from an injury or a reduction of
function of the heart muscle.
 Can be due to arteriosclerosis, hypertension,
myocardial infarction, rheumatic fever or
birth defect.

Congestive Heart Failure



The right side of the heart collects the blood
returning from the body and sends it to the lungs.
If it is failing, the blood backs up into the veins,
and there are signs of edema.
The left side of the heart receives the blood from
the lungs and pumps it out into the body. If it is
failing the blood is not pumped effectively.
Cerebrovascular Accident
or
Stroke

Blood vessel in the brain becomes blocked
by atherosclerosis- the tissue supplied by
the artery dies.

Embolus – which is a traveling blood clot.
Symptoms of Stroke
Sudden numbness or weakness of the face,
arm or leg, especially on one side of the
body.
 Sudden confusion, trouble speaking, or
understanding.
 Sudden trouble seeing in one or both eyes.
 Sudden trouble walking, dizziness, loss of
balance or coordination.

Symptoms of Stroke
Sudden severe headache with no known
cause.
 If you have any of these symptoms you
need immediate medical attention!

Unchangeable Risk Factors
Age- the older you get, the greater the
chance.
 Sex- males have a greater rate even after
women pass menopause.
 Race- minorities have a greater chance.
 Family history- if family members have had
CHD, there is a greater chance.

Unchangeable Risk Factors

Personal Medical History- other diseases
such as Diabetes Mellitus can increase
chances.
Changeable Risk Factors
Hypertension
 Serum cholesterol
 Obesity
 Diabetes Mellitus
 Physical Inactivity
 Cigarette Smoking
 Alcohol Intake

Cholesterol
Everybody needs cholesterol, it serves a
vital function in the body.
 It is a component of the nerve tissue of the
brain and spinal cord as well as other major
organs.
 Frequently measured to promote health and
prevent disease.
 A major component of the plaque that clogs
arteries.

Types of Cholesterol
Lipoproteins- 4 main classes
Chylomicrons
 Very low density lipoproteins (VLDL)
 Low Density Lipoprotein (LDL)
 High Density Lipoprotein (HDL)

Good vs. BAD
LDL is known as bad cholesterol. It has a
tendency to increase risk of CHD.
 LDL’s are a major component of the
atherosclerotic plaque that clogs arteries.
 Levels should be <130

Good vs. BAD
HDL is known as the good cholesterol.
 It helps carry some of the bad cholesterol
out of the body.
 It does not have the tendency to clog
arteries.
 Levels should be >35.
 High levels of HDL >60 can actually negate
one other risk factor.

The Facts About Fat
Certain fats are essential for good nutrition
and health.
 Fats provide essential fatty acids which the
body can’t manufacture.
 Act as insulators to maintain body
temperature.
 Improve the palatability of food and
promote digestion.

The Facts About Fat
Provide the greatest energy output per gram
of any food source. ( 9 cals)
 Carry fat soluble vitamins- A,D,E, and K.

The Skinny on Fat
Saturated fats- basically means the fat is
saturated with hydrogen, they are solid at
room temperature. Examples are lard and
butter.
 Why are they bad for you? They increase
levels of LDL , decrease HDL and increase
total cholesterol.

The Skinny on Fat
What are polyunsaturated fats? They are
unsaturated fats which are liquid at room
temperature and in the refrigerator.
 Why are they good for us?
 They help the body get rid of newly formed
cholesterol.

The Skinny on Fat
What are monounsaturated fats?
 They are liquid at room temperature but
start to solidify in the refrigerator.
 Decrease total cholesterol and lower LDL
levels.

The Skinny on Fat
What are trans fatty acids? They are
unsaturated fats but they tend to raise total
and bad cholesterol.
 Where do you find them?
 In fast-food restaurants
 Commercial baked goods. Examples:
doughnuts, potato chips, cupcakes.

What about Omega 3?
Type of polyunsaturated fat.
 Consistently lowers serum triglycerides and
may also have an effect on lowering blood
pressure.
 Found in oily fish such as salmon, tuna, and
herring.
 Is available as a supplement.

Obesity
People who are obese have 2 to 6 times the
risk of developing hypertension.
 Location of the body fat is significant.
 Pears of apples?

Diabetes Mellitus
At any given cholesterol level, diabetic
persons have a 2 or 3 x higher risk of
atherosclerosis!
 Insulin is required to maintain adequate
levels of lipoprotein lipase, an enzyme
needed to break down bad cholesterols.

Physical Inactivity
Increasing physical activity has been shown
to decrease blood pressure.
 Moderate to intense physical activity for 3045 minutes on most days of the week is
recommended.

Cigarette Smoking
Causes an increase in blood pressure
 Usually have lower levels of HDL
 Within 1 year of quitting, CHD risk
decreases, within 2 years it reaches the level
of a nonsmoker.

Alcohol Consumption
In small amounts it acts as a vasodilatorGood! 1-2 drinks
 In large amounts it acts as a vasoconstrictorBAD! 3-4 drinks
 This is a very fine line!

Treatment

Cardiac Catherization - Dr. inserts a plastic
tube into an artery or vein and injects a dye,
this can help to determine where the
blockages are. Also a good method to
determine the amount of blood and oxygen
the heart is receiving.
Treatment

Coronary Artery Bypass Surgery (CABG)
The most frequently performed major
surgery in the United States. Surgery
reroutes or bypasses blood around clogged
arteries.
Treatment

Angioplasty (PCTA)
It involves creating a space in a blocker
artery by inserting a small balloon and then
inflating it. Now includes the placement of a
mesh stent to improve effectiveness.
How can You Stop CVD?
Diet and Nutrition, there are several
guidelines listed by the American Heart
Association:
 Eat a variety of fruits and vegetables every
day. ( 5 servings - they are naturally low in
fat and high in vitamins and minerals)
 Eat a variety of grain products ( 6 a day)
Diet and Prevention of CVD
Choose nonfat or low-fat products.
 Use lean meats- choose chicken, fish, turkey
and lean cuts of beef and pork.
 Switch to fat-free milk- gradually reduce the
fat content of the milk you drink.

Dietary Guidelines
Choose fats with 2 gms or less of saturated
fats per serving such as liquid and tub
margarines, canola oil and olive oil.
 Balance the # of calories you eat with the
number of calories you use each day.
 Maintain a level of physical activity that
keeps you fit and matches the # of calories
you eat.

Dietary Guidelines
Limit your intake of foods high in calories
and low in nutrition, including foods like
soft drinks and candy.
 Limit foods high in saturated fat, trans fat
and cholesterol
 Eat less than 6 gms of salt a day
 Have no more than one alcoholic drink a
day.

Step I and II Diets
The AHA and NCEP have developed these
diets to treat high blood pressure and
hypercholesterolemia
 They are designed to lower LDL levels,
while at the same time promoting good
nutrition.

Step I







Total fat- 30% or less
Sat fat- 7-10%
Poly - up to 10%
Mono Up to 15%
Carb 55% or more
Pro Approx 15%
Chol. less than 300mg
Step II







30% or less
7%
up to 10%
up to 15%
55% or more
Approx 15%
less than 200 mg
Exercise and CVD
Serves several functions in preventing and
treating those at high risk.
 Reduces incidence of obesity.
 Increases HDL
 Lowers LDL and total cholesterol
 Helps control diabetes and hypertension
 Those at high risk should take part in a
specially supervised program.

Conclusion
Cardiovascular disease is the number one
killer.
 It is highly preventable and controllable
with diet and exercise.
 Good resource: www.americanheart.org
 1-800-AHA-USA
